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手术联合放疗及外用硅酮凝胶治疗腋窝瘢痕的疗效观察 预览

Therapeutic Effect of Plastic Surgery Combined with Radionuclide Radiotherapy and Topical Silicone Gel on Axillary Scar
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摘要 目的:观察减张缝合、核素放疗联合外用硅酮凝胶治疗腋窝瘢痕的疗效。方法:选取笔者医院2014年1月-2018年1月收治的104例腋窝瘢痕患者,按随机数表法分为观察组与对照组,各52例。两组均采取手术切除瘢痕疙瘩,对照组采取传统缝合+核素放疗+激素治疗+外用硅酮凝胶,观察组采取减张缝合+核素放疗+激素治疗+外用硅酮凝胶。比较两组总有效率、治疗前后的瘢痕程度[采用温哥华瘢痕量表(Vancouver scar scale,VSS)评估]、瘢痕硬度[采用WX-2A型硬度计测量]、瘢痕美观度[采用患者和观测者瘢痕评价量表(Patient and observer scar assessment scale,POSAS)评估]及随访至2018年7月的复发率。结果:观察组治疗总有效率为96.15%,高于对照组的84.62%,差异有统计学意义(P<0.05)。治疗后,两组VSS总评分均较治疗前降低,且观察组为(2.84±0.56)分显著低于对照组的(3.66±0.63)分,差异有统计学意义(P<0.05)。两组瘢痕硬度与POSAS评分均较治疗前降低,观察组治疗后的瘢痕硬度与POSAS评分[(0.61±0.14)N/mm3与(10.28±2.31)分]低于对照组[(0.68±0.17)N/mm3与(14.29±2.60)分],差异有统计学意义(P<0.05)。截至2018年7月,观察组失访3例、对照组失访2例。观察组随访期间复发率[4.08%(2/49)]低于对照组[16.00%(8/50)],差异有统计学意义(P<0.05)。结论:减张缝合、核素放疗、激素治疗联合外用硅酮凝胶治疗腋窝瘢痕可减小切口张力,抑制切口瘢痕的增宽与增生,治疗总有效率更高,外观恢复更理想,复发风险更低,为瘢痕疙瘩的理想治疗方案。 Objective To observe the effect of reduction suture,radionuclide radiotherapy combined with topical silicone gel on axillary scar.Methods A total of 104 patients with axillary scars admitted to our hospital from January 2014 to January 2018 were randomly divided into observation group and control group,with 52 cases in each group.Both groups performed surgical removal of keloids.The control group was treated with conventional suture+radionuclide radiotherapy+hormone therapy+topical silicone gel,and the observation group was treated with reduction suture+radionuclide radiotherapy+hormone therapy+topical silicone gel.The total effective rate of the two groups,the degree of scar before and after treatment[assessed by the Vancouver scar scale(VSS)],the scar hardness[measured by the WX-2A hardness tester],and the scar aesthetics[assessed by the Patient and observer scar evaluation scale(POSAS)]and the recurrence rate followed up to July 2018 were compared between the two groups.Results The total effective rate of the observation group was 96.15%,which was higher than that in the control group(84.62%),the difference was statistically significant(P<0.05).After treatment,the VSS total scores of the two groups were lower than those before treatment,the VSS total score in the observation group[(2.84±0.56)points]was significantly lower than that in the control group[(3.66±0.63)points,P<0.05].The scar hardness and POSAS scores of the two groups were lower than those before treatment,the scar hardness and POSAS scores in the observation group after treatment[(0.61±0.14)N/mm3 and(10.28±2.31)points]were lower than those in the control group[(0.68±0.17)N/mm3 and(14.29±2.60)points,P<0.05].As of July 2018,the observation group lost 3 cases,and the control group lost 2 cases.The recurrence rate of observation group[4.08%(2/49)]was lower than that of control group[16.00%(8/50)],and the difference was statistically significant(P<0.05).Conclusion The reduction of suture,radionuclide radiotherapy,hormone therapy combined with top
作者 赵坤 杨帆 姚忠军 徐风瑞 ZHAO Kun;YANG Fan;YAO Zhong-jun;XU Feng-rui(Department of Plastic Burn Surgery,Taihe Hospital,Shiyan 442000,Hubei,China)
出处 《中国美容医学》 CAS 2019年第1期45-48,共4页 Chinese Journal of Aesthetic Medicine
关键词 瘢痕疙瘩 腋窝 减张缝合 核素放疗 硅酮凝胶 激素治疗 keloid axillary fossa reduction suture radionuclide radiotherapy silicone gel hormone therapy
作者简介 第一作者:赵坤,十堰市太和医院整形烧伤科,硕士,主治医师;研究方向:瘢痕的治疗;E-mail:stc917@126.com
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